Calcium channel blockers are drugs that reduce the movement of calcium into cells of the heart and vessels. This reduces the strength of heart contractions and relaxes the arteries, allowing them to remain more open, lowering blood pressure. Side effects of calcium channel blockers can include heart palpitations, dizziness, swollen ankles, and constipation. Calcium channel blockers can be taken alone or with other blood pressure medications. They should be taken with food or milk. Because of potential interactions, those taking calcium channel blockers should avoid alcohol and grapefruit juice.
On physical examination, hypertension may be associated with the presence of changes in the optic fundus seen by ophthalmoscopy.[22] The severity of the changes typical of hypertensive retinopathy is graded from I to IV; grades I and II may be difficult to differentiate.[22] The severity of the retinopathy correlates roughly with the duration or the severity of the hypertension.[20]

With age, comes an increased risk for systolic hypertension which can be aggravated by severe atherosclerosis. According to one study, the diuretic chlorthalidone (Hygroton) had significant benefit in elderly patients with systolic hypertension. Along with a diuretic, some calcium channel blockers, ACE inhibitors and angiotensin II receptor blockers may also be good choices. However, beta blockers may not be as effective for hypertension in those over 60; though they may be good choices if co-existing heart disease is present. It also may be preferable in elderly patients to give two high blood pressure medications at a low dose versus one at a higher dose.


Generally, blood pressure tends to be higher if more blood is pumped into the arteries or if the arterioles are narrow and/or stiff. Narrow and/or stiff arterioles, by resisting the flow of blood, increase blood pressure. Arterioles may become narrower when the muscles surrounding them contract. Arterioles may become stiff and narrow when older patients develop atherosclerosis.
Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is called diastolic pressure.

If you have high blood pressure, it is important to get routine medical care and to follow your prescribed treatment plan, which will include heart-healthy lifestyle changes and possibly medicines. Heart-healthy lifestyle changes can prevent high blood pressure, reduce elevated blood pressure, help control existing high blood pressure, and prevent complications, such as heart attack, heart failure, stroke, vascular dementia, or chronic kidney disease.


Blood pressure monitors for use at home can be bought at drug stores, department stores, and other places. Again, these monitors may not always give you a correct reading. You should always compare your machine’s reading with a reading from your doctor’s machine to make sure they are the same. Remember that any measurement above normal should prompt a visit to the doctor, who can then talk with you about the best course of action.
Pre-eclampsia is a serious condition of the second half of pregnancy and following delivery characterised by increased blood pressure and the presence of protein in the urine.[23] It occurs in about 5% of pregnancies and is responsible for approximately 16% of all maternal deaths globally.[23] Pre-eclampsia also doubles the risk of death of the baby around the time of birth.[23] Usually there are no symptoms in pre-eclampsia and it is detected by routine screening. When symptoms of pre-eclampsia occur the most common are headache, visual disturbance (often "flashing lights"), vomiting, pain over the stomach, and swelling. Pre-eclampsia can occasionally progress to a life-threatening condition called eclampsia, which is a hypertensive emergency and has several serious complications including vision loss, brain swelling, seizures, kidney failure, pulmonary edema, and disseminated intravascular coagulation (a blood clotting disorder).[23][31]
Extremely high levels of blood pressure, i.e. systolic above 180 mm Hg or diastolic above 110 mm Hg requires immediate medical attention. Delayed treatment in such cases may result in various hypertensive emergencies like stroke, heart attack, hypertensive encephalopathy, malignant hypertension, aortic dissection, etc. These conditions may cause death.
Exercise stress test: More commonly used for patients with borderline hypertension. This usually involves pedaling a stationary bicycle or walking on a treadmill. The stress test assesses how the body's cardiovascular system responds to increased physical activity. If the patient has hypertension this data is important to know before the exercise test starts. The test monitors the electrical activity of the heart, as well as the patient's blood pressure during exercise. An exercise stress test sometimes reveals problems that are not apparent when the body is resting. Imaging scans of the heart's blood supply might be done at the same time.
Being overweight increases the risk of getting hypertension and increases the workload required of your heart. Diets designed to control blood pressure are often designed to reduce calories as well. Most of these diets require decreasing consumption of fatty foods and sugars while increasing your intake of lean protein, fiber, fruits, and vegetables. A weight loss of just 10 pounds can make a significant difference in your blood pressure.

One especially important cause of low blood pressure is orthostatic hypotension, which is sometimes referred to as postural hypotension. This happens when blood pressure drops rapidly during changes in body position—usually when changing from sitting to standing—inducing classic signs that the blood pressure is too low, like dizziness, blurry vision, and fainting.
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High blood pressure is the most common chronic medical problem prompting visits to primary health care providers in USA. The American Heart Association estimated the direct and indirect costs of high blood pressure in 2010 as $76.6 billion.[144] In the US 80% of people with hypertension are aware of their condition, 71% take some antihypertensive medication, but only 48% of people aware that they have hypertension adequately control it.[144] Adequate management of hypertension can be hampered by inadequacies in the diagnosis, treatment, or control of high blood pressure.[164] Health care providers face many obstacles to achieving blood pressure control, including resistance to taking multiple medications to reach blood pressure goals. People also face the challenges of adhering to medicine schedules and making lifestyle changes. Nonetheless, the achievement of blood pressure goals is possible, and most importantly, lowering blood pressure significantly reduces the risk of death due to heart disease and stroke, the development of other debilitating conditions, and the cost associated with advanced medical care.[165][166]
^ Nagele, Eva; Jeitler, Klaus; Horvath, Karl; Semlitsch, Thomas; Posch, Nicole; Herrmann, Kirsten H.; Grouven, Ulrich; Hermanns, Tatjana; Hemkens, Lars G.; Siebenhofer, Andrea (2014). "Clinical effectiveness of stress-reduction techniques in patients with hypertension". Journal of Hypertension. 32 (10): 1936–44. doi:10.1097/HJH.0000000000000298. ISSN 0263-6352. PMID 25084308.
I just started using high blood pressure medication and purchased a blood pressure meter at age 72. what concerns me is that the BP readings I get have a very wide variance in. I measure every morning as soon as I wake up, while still in bed and prior to having any coffee. I take 3 or 4 readings. I have found that on any given day my reading can vary from 126 to 143 systolic and the diastolic reading from 68 to 87. this wide variance makes it very difficult to track trends. My questions are: is this normal? is my instrument possibly defective? How can my cardiac doctor make a decision to put me on life long medication based on SINGLE reading in his office?
To make an official diagnosis of high blood pressure you will need to see your doctor. Often your blood pressure will be checked on at least two different visits, at different times of the day. Your doctor may ask you to keep a blood pressure log for a short time in order to see your overall blood pressure trends. If your blood pressure is consistently over 134/80, your doctor will work with you to determine the best regimen for treating your high blood pressure.
Unlike high blood pressure, low blood pressure is defined primarily by signs and symptoms of low blood flow and not by a specific blood pressure number. Some individuals routinely may have blood pressure numbers of 90/50 with no symptoms and therefore do not have low blood pressure. However, others who normally have higher blood pressures may develop symptoms of low blood pressure if their blood pressure drops to 100/60.
^ Roerecke, Michael; Tobe, Sheldon W.; Kaczorowski, Janusz; Bacon, Simon L.; Vafaei, Afshin; Hasan, Omer S. M.; Krishnan, Rohin J.; Raifu, Amidu O.; Rehm, Jürgen (27 June 2018). "Sex‐Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta‐Analysis of Cohort Studies". Journal of the American Heart Association. 7 (13): e008202. doi:10.1161/JAHA.117.008202.
Heart attack. Signs of heart attack include mild or severe chest pain or discomfort in the center of the chest or upper abdomen that lasts for more than a few minutes or goes away and comes back. It can feel like pressure, squeezing, fullness, heartburn, or indigestion. There may also be pain down the left arm. Women may also have chest pain and pain down the left arm, but they are more likely to have less typical symptoms, such as shortness of breath, nausea, vomiting, unusual tiredness, and pain in the back, shoulders, or jaw. Read more about the signs and symptoms of a heart attack.
The first chemical for hypertension, sodium thiocyanate, was used in 1900 but had many side effects and was unpopular.[152] Several other agents were developed after the Second World War, the most popular and reasonably effective of which were tetramethylammonium chloride, hexamethonium, hydralazine, and reserpine (derived from the medicinal plant Rauwolfia serpentina). None of these were well tolerated.[159][160] A major breakthrough was achieved with the discovery of the first well-tolerated orally available agents. The first was chlorothiazide, the first thiazide diuretic and developed from the antibiotic sulfanilamide, which became available in 1958.[152][161] Subsequently, beta blockers, calcium channel blockers, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers, and renin inhibitors were developed as antihypertensive agents.[158]
This study will assess whether minocycline, an antibiotic with anti-inflammatory effects, can improve blood pressure control in patients who do not respond to medicines in combination with lifestyle changes, such as physical activity, weight loss, and healthy eating patterns. To participate you must be at least 18 years old and have high blood pressure that does not respond to treatment with three different high blood pressure medicines even when used at the maximum doses. Please note that this study is in Gainesville, Florida.

This study will assess whether minocycline, an antibiotic with anti-inflammatory effects, can improve blood pressure control in patients who do not respond to medicines in combination with lifestyle changes, such as physical activity, weight loss, and healthy eating patterns. To participate you must be at least 18 years old and have high blood pressure that does not respond to treatment with three different high blood pressure medicines even when used at the maximum doses. Please note that this study is in Gainesville, Florida.
Many kids and teens with high blood pressure have an unhealthy lifestyle — a bad diet, excess weight, stress, and too little physical activity. So the health care provider might recommend weight loss, exercise, reduced screen time (time spent watching TV, or using a computer or mobile devices), dietary changes, and even relaxation techniques. Teens with hypertension should not smoke because it can make the long-term associated heart problems worse.

Bahar Gholipour is a staff reporter for Live Science covering neuroscience, odd medical cases and all things health. She holds a Master of Science degree in neuroscience from the École Normale Supérieure (ENS) in Paris, and has done graduate-level work in science journalism at the State University of New York at Stony Brook. She has worked as a research assistant at the Laboratoire de Neurosciences Cognitives at ENS.
4. Find an exercise that works for you (and do it). Moving more can help reverse high blood pressure. One meta-analysis of 65 studies found regular exercise provides both an acute and longer-term reduction in blood pressure. Whether you’re an exercise novice or a conditioned athlete, these four strategies can help you create an effective workout plan to optimize health.
A 2015 review of several studies found that restoring blood vitamin D levels by using supplements (more than 1,000 IU per day) reduced blood pressure in hypertensive individuals when they had existing vitamin D deficiency.[167] The results also demonstrated a correlation of chronically low vitamin D levels with a higher chance of becoming hypertensive. Supplementation with vitamin D over 18 months in normotensive individuals with vitamin D deficiency did not significantly affect blood pressure.[167]
To make an official diagnosis of high blood pressure you will need to see your doctor. Often your blood pressure will be checked on at least two different visits, at different times of the day. Your doctor may ask you to keep a blood pressure log for a short time in order to see your overall blood pressure trends. If your blood pressure is consistently over 134/80, your doctor will work with you to determine the best regimen for treating your high blood pressure.
Many things can cause your blood pressure to be too low, ranging from normal pregnancy-induced changes to dangerous underlying conditions, like heart problems or hormone disturbances. In some instances, what causes low blood pressure could be a simple case of dehydration brought on by vomiting, intense exercise, or the overuse of diuretics. In fact, even mild dehydration can trigger symptoms such as dizziness, confusion, or other symptoms of low blood pressure.
Dehydration can sometimes cause blood pressure to drop. However, dehydration does not always cause low blood pressure. Fever, vomiting, severe diarrhea, overuse of diuretics and strenuous exercise can all lead to dehydration, a potentially serious condition in which your body loses more water than you take in. Even mild dehydration (a loss of as little as 1 percent to 2 percent of body weight) can cause weakness, dizziness and fatigue.
With age, comes an increased risk for systolic hypertension which can be aggravated by severe atherosclerosis. According to one study, the diuretic chlorthalidone (Hygroton) had significant benefit in elderly patients with systolic hypertension. Along with a diuretic, some calcium channel blockers, ACE inhibitors and angiotensin II receptor blockers may also be good choices. However, beta blockers may not be as effective for hypertension in those over 60; though they may be good choices if co-existing heart disease is present. It also may be preferable in elderly patients to give two high blood pressure medications at a low dose versus one at a higher dose.
Many things can cause your blood pressure to be too low, ranging from normal pregnancy-induced changes to dangerous underlying conditions, like heart problems or hormone disturbances. In some instances, what causes low blood pressure could be a simple case of dehydration brought on by vomiting, intense exercise, or the overuse of diuretics. In fact, even mild dehydration can trigger symptoms such as dizziness, confusion, or other symptoms of low blood pressure.
Keeping track of your blood pressure is important. Your doctor can help you learn how to check your blood pressure at home. Each time you check your own blood pressure, record your numbers and the date. Send or take the log of your blood pressure readings with you for appointments with your doctor. Return to Screening for reminders on how to prepare for blood pressure testing.
Hispanic Community Health Study/Study of Latinos (HCHS/SOL). The NHLBI supports the HCHS/SOL, which is the most comprehensive long-term study of health and disease in Hispanics and Latinos living in the United States. Study data will pave the way for future research into possible causes of health disparities among Hispanic and Latino communities. Visit Hispanic Community Health Study/Study of Latinos for more information.

There are even more medication types that can lower blood pressure. Some of these are alpha blockers, vasodilators, and central alpha agonists. Your doctor may prescribe these medications if other medications have been ineffective or if you have another condition along with hypertension. Side effects can include fast pulse, palpitations, dizziness, diarrhea, or headaches.
Sodium is a key part of how the body controls blood pressure levels. The kidneys help balance fluid and sodium levels in the body. They use sodium and potassium to remove excess fluid from the blood. The body gets rid of this excess fluid as urine. When sodium levels in the blood are high, blood vessels retain more fluid. This increases blood pressure against the blood vessel walls.

However, if a patient has any kind of cardiovascular disease and stage 1 hypertension (a blood pressure over 130 systolic or 80 diastolic), or no existing cardiovascular disease but a significant risk of developing it (over 10% risk within the next 10 years), then lifestyle changes plus medications are recommended. And, even if someone has less than a 10% risk, if their blood pressure is over 140 systolic or 90 diastolic, which is now stage 2 high blood pressure, they ought to be treated with medication as well.


You may be directed to seek medical care if blood pressure readings are elevated if done as part of a community health screening. Isolated elevated blood pressure readings do not necessarily make the diagnosis of hypertension. Blood pressure readings vary throughout the day, and your primary care provider may record a different reading than the one that was measured in a screening that sent you in for care.


tilt table test – usually recommended if your doctor suspects you might have orthostatic hypotension or NMH (During this diagnostic test, a person lies on a table and then the table is tilted to raise the upper part of their body. This simulates the change in position from sitting or lying down to standing up. People with orthostatic hypotension or NMH may feel dizzy, lightheaded, or even faint when their position changes.)
^ Jump up to: a b c d e National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (August 2004). "The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents". Pediatrics. 114 (2 Suppl 4th Report): 555–76. doi:10.1542/peds.114.2.S2.555. PMID 15286277.
Early signs of pulmonary arterial hypertension can be related to the trouble you have getting blood to your lungs to get oxygenated. You might experience shortness of breath and a fast heart beat while doing activities that are otherwise routine, such as climbing stairs. You might also have chest pain, a reduced appetite, and pain in your chest or upper right portion of your abdomen.
Sodium, a chemical found in salt, raises blood pressure by promoting the retention of fluid by the body. This increases the workload on the heart. The American Heart Association recommends an upper daily limit for sodium consumption of 1,500 mg. Checking food labels and menus can help you calculate how much sodium you are consuming. Processed foods are particularly high in sodium and make up about 75% of our sodium intake. Among these, lunch meats and canned soups have some of the highest levels of dietary sodium.
Determining the normal blood pressure range in children is a little complicated, and it all depends on the size and age of the child. One rule of thumb that doctors use to determine BP troubles in children is that, a child is considered to be suffering from Prehypertension. If he/she has a blood pressure higher than that of 90% of the children of the same age and size. The child is said to have hypertension if he/she has a blood pressure higher than that of 95% of the children of the same age and size.
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps out blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is the diastolic pressure. Your blood pressure reading uses these two numbers. Usually they're written one above or before the other, such as 120/80. If your blood pressure reading is 90/60 or lower, you have low blood pressure.
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